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Early Presentation of Successive Acute Retinal Necrosis Decades After Initial Infection
Hao-Tinh Le1, Natasha Kesav1, Ankur Mehra1
1Department of Ophthalmology, Case Western Reserve University Hospital, Cleveland, OH, USA.
Journal of Vitreoretinal Diseases
|November 14, 2024
Summary
This case study highlights successive acute retinal necrosis (ARN) presenting decades after initial infection. Early clinical diagnosis and aggressive antiviral treatment are crucial for maintaining vision, even if viral testing is negative.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Acute retinal necrosis (ARN) is a severe viral retinitis.
- Delayed recurrence of ARN can occur decades after initial infection.
Observation:
- A 62-year-old male with a history of ARN presented with blurry vision in the contralateral eye.
- Clinical examination revealed characteristic signs of ARN, including anterior chamber inflammation and retinitis.
- Despite antiviral treatment, the lesions progressed, necessitating intensive therapy.
Findings:
- Viral testing of aqueous samples was negative.
- The patient's ARN responded well to aggressive antiviral therapy, preserving visual acuity.
- Diagnosis of ARN was primarily clinical, guiding treatment decisions.
Implications:
- ARN diagnosis should be based on clinical presentation, especially in cases with negative confirmatory tests.
- Prompt and aggressive antiviral treatment is essential for managing ARN and preventing vision loss.
- Ophthalmologists should consider delayed recurrence of ARN in patients with a history of the condition.
